Genotype change technology now in Nigeria – UNIBEN don

Dr. Godwin BazuayeDr. Godwin Bazuaye is a consultant dermatologist and specialist in bone marrow transplants. He graduated from the University of Benin and trained in the same school. He later  went to Swizerland for sub-specialization in bone marrow transplantation. Currently, he is head of Human Dermatology and Co-ordinator of Stem Cell Transplant Unit at the University of Benin Teaching Hospital, UBTH.

During the recent visit by the National Good Governance Tour team to the Hospital, he told  us in an exclusive interview, how the hospital successfully completed two stem cell transplants and how Nigerian can benefit from the technology locally, rather than going abroad to change their genotype, especially sickle cell patients. Excerpts:

What is stem cell Transplant?
It is a new model way of treating patients, where we have to transfer stem cells. These are cells that have the ability to produce new cells from a donor that is normal to a patient who has one illness or the other, after we have destroyed bone marrows, so that the new cells from the donor will produce new cells in the patient, which is almost like that of the donor. So, if you have a patient, whose genotype is SS, we will transplant cells that are AA from a normal person; the cells in the person will start producing AA.

How does it work?
You have to enable the body accept new cells to be transplanted. In this unit, you can change the genotype of a child or an individual from sickle cell to AA. You bring a primitive cell from a donor to a recipient. Before this time, you would have reduced the immunity in the patient to the barest minimum so that he can accept what you are giving to him, called stem cell. It can also be used for cancer patients. Major beneficiaries are sickle cell patients. Once  it is done, they are no longer sicklers.

Are there risks involved?
We don’t collect blood from the veins; we have to use a needle on the bone marrow to bring out blood. Usually, the risk is very minimal. To the donor, there is no risk in the procedure, except the risk that has to do with going to the theatre. Apparently, the last one we did was a 14 year-old boy. By the third day, he had gone home and he resumed school the next day. For the patient, the risk is very low, as it has to do with the hard drugs, which the body could react to. For the patient, they are placed on very high drugs in the course of destroying the bone marrow. It could lead to side effects reaction.

How successful was your last procedure?
It was okay, the patient is a year and two months. His genotype was AA and has not had any crisis since then and so, I will say that it was quite successful.

At what age can one qualify for this transplant.?
The therapy is used for both the sickle cell and blood cancer patients; in fact, anything that has to do with taking a cell from a donor to cure the patient. Really, for sickle cell patients, it is preferable when they are 15 years and below because when they are older, they tend to need a lot of blood transfusion, their organs may get damaged. Although, there is a new method we use for adult sickle cell patients; that is also to change their genotype to AS.

How many of these procedures have you done so far?
We have done two. The first one is a year plus now and the second, we just discharged the patient.

Minimum cost?
Well, on the average, it costs between N8m-N6m, depending on the number of supportive care. That is when we are doing a sickle patient. If we have the support of the Federal Government in the way of subsidizing the equipments in a space that is big enough to take five to10 people at a time, then it will reduce the cost. We need a good international centre with a lot of transplant rooms, so that if we are doing more than one, we can share the cost. Like now, we have to run generator for one hundred days for an individual. If it is for five individuals, it makes it easier and the cost will definitely trickle down to maybe N2m.

How long does it take to carry out a procedure?
It takes an average of three months or 100 days because at that period, you have a lot of tests and checks involved, though some may be discharged before one hundred days.

How many of you are trained in this specialty?
For now, I am the only one trained in the hospital.

Who are your major targets in this project?
The therapy is good for both sickle cell and anything that has to do with cell transplant. This is the first in West Africa and third in the whole of Africa, after Egypt and South Africa. This can be replicated in the six geo-political zones. India for instance, has about 20 centres. An average of N1 billion should be able to set up a centre.

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